Reviewing the Trends of Nursing Doctoral Thesis Research in Hong Kong
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Open Journal of Nursing, 2012, 2, 346-350 OJN http://dx.doi.org/10.4236/ojn.2012.24051 Published Online December 2012 (http://www.SciRP.org/journal/ojn/) Reviewing the trends of nursing doctoral thesis research in Hong Kong Yingchun Zeng1*, Samantha Pang2 1Department of Health and Physical Education, The Hong Kong Institute of Education, Hong Kong, China 2School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China Email: *[email protected] Received 14 August 2012; revised 18 September 2012; accepted 28 October 2012 ABSTRACT and leaders for the dynamic healthcare environment [1]. In recent years, three universities have run taught doc- This review aimed to analyze the trends and contri- toral programs specific to the professional practice of butions of nursing doctoral theses produced in Hong nursing: the Hong Kong Polytechnic University (PolyU) Kong. A total of 56 nursing doctoral theses were in- School of Nursing has provided a Doctor of Health Sci- cluded in this review. The most often studied topic ence (DHSc) program since 2004; the Chinese Univer- was cardiovascular rehabilitation care (n = 9, 16%). sity of Hong Kong (CUHK) Nethersole School of Nurs- More recently, the most often studied topics has been ing has provided a Doctor of Nursing (DN) program health technology advancements in nursing care (n = since 2009; and the University of Hong Kong (HKU) 6, 10.7%). The common trend of study methods was School of Nursing has offered a DN program since 2010. to be quantitative in nature. Of the total, 35 out of 56 The defining feature of doctoral study is that nurse were quantitative studies. Half were experimental/ leaders are nurtured to generate and extend nursing quasi-experimental research studies (n = 28, 50%). knowledge and to use their expertise to lead the devel- For theoretical foundations or applications, the ma- opment of the nursing discipline [2,3]. The doctoral the- jority (n = 21, 36%) of doctoral theses had no specific sis is the capstone event of doctoral study. While devel- theoretical/conceptual models as study frameworks. oping their theses, doctoral students discover the cutting This trend indicates that there is space for improving edge of the discipline [4]. Reviewing nursing doctoral the theoretical and philosophical foundation of nurs- theses could identify changing trends in the nursing pro- ing research in Hong Kong. For the contributions of fession as an academic discipline. Of the few published doctoral thesis research, Hong Kong nursing scholars reviews of nursing doctoral research that have studied place more emphasis on direct enhancement of clini- nursing dissertations/theses [5-8], none was conducted in cal practice or the improvement of patient outcomes. HK. With a growing body of nursing doctoral theses in This review provides concrete evidence of the status HK, the aim of this review was to analyze the trends and of nursing research and knowledge development in contributions of these existing nursing doctoral theses. Hong Kong nursing. 2. METHODS Keywords: Nursing; Doctoral Education; Doctoral Thesis; Hong Kong Three key word combinations were used to conduct the search: Nursing, doctoral theses and PolyU or CUHK or HKU among the Dissertations & Theses Collection at 1. INTRODUCTION Hong Kong Polytechnic University, the Dissertations and Theses Collection Consortium and the ProQuest Disser- Doctoral education for preparing nursing scholars com- tations and Theses. The inclusion criteria included nurs- menced in Hong Kong (HK) around 1995. Doctoral ing-focused doctoral dissertation studies, conducted in nursing programs in HK incorporate the strengths of both three universities in Hong Kong, written in English or the British model of mentored research training and the Chinese, for the academic degree of PhD or DHSc, and US model of formal course offering. With the global completed between 1996 and 2010 (at the time of trend of technological advances and interdisciplinary searching, there were no completed DN dissertations). care, the PhD nursing program alone could not meet the The exclusion criteria included those theses were not challenges of preparing nurses as researchers, teachers, with a focus on nursing. As one nursing school before *Corresponding author. 2002 was named as Department of Nursing and Health OPEN ACCESS Y. C. Zeng, S. Pang / Open Journal of Nursing 2 (2012) 346-350 347 Sciences, which included other health-related disciplines/ Table 1. Nursing doctoral theses by general topical categories majors. The theses were read and studied, classified by (N = 56). topic, methods of investigation and theoretical founda- Topic n % tion or application, and analyzed using descriptive statis- Cardiovascular rehabilitation care 9 16.0 tics. Gerontology 8 14.2 3. RESULTS Cancer care 6 10.7 Digital health/health technology advancement 6 10.7 A total of 56 doctoral theses were included. Three theses were from the DHSc program, which is mainly focusing Maternity care 5 8.9 on training professional practitioners for playing the Public health/health behaviors 5 8.9 leadership role in clinical healthcare settings. The others Childhood and family health 4 7.2 were from the PhD program, which is mainly with a re- Palliative care 2 3.6 search focus on training researchers and educators for Pain management 2 3.6 research centers or educational institutes. The number of theses produced in Hong Kong per year from 1996 to Professional practice/development 2 3.6 2010 is shown in Figure 1. Since 2000, there have been Nursing education 2 3.6 an increasing number of theses produced per year. In Mental health 1 1.8 2003, there was only one graduate from a PhD program. Nursing ethics 1 1.8 Possibly due to the outbreak of SARS in China, public Healthcare system issues 1 1.8 gathering activities, including oral defense of doctoral Instrument development and validation 1 1.8 theses, may not have been encouraged in that year. The distribution of these nursing doctoral theses was Theory model testing 1 1.8 classified by general study topics and the life span. The classification of general study topics can be seen in Ta- on adult health (n = 42, 75%), followed by elderly care ble 1. According to clinical specialty, cardiovascular (n = 8, 14.3%), child health (n = 4, 7.1%), and end-of- care/rehabilitation (n = 9, 16%) were the most often- life care (n = 2, 3.6%). studied topics, followed by gerontology (n = 8, 14.2%), Table 2 provides a descriptive summary of all doctoral cancer care (n = 6, 10.7%), and maternity care (n = 5, thesis studies by the method of investigation. Of the total, 8.9%). With an increasing trend toward interdisciplinary it appears that 35 out of 56 were quantitative studies that care, digital health/health technology advancement has were developed from classical models such as descrip- become one of the most frequently-studied topics in tive (n = 2, 3.6%), exploratory (n = 5, 8.9%), and ex- nursing doctoral research in HK. Six theses investigated perimental/quasi-experimental research (n = 28, 50%). the feasibility and reliability of non-invasive methods in These data reflect the growing trend of experimental screening hypertension or blood glucose measurement. studies that have become a major approach in doctoral In terms of the life span, the majority of theses focused research in HK. The qualitative studies, in turn, totaled 12 and were developed from methods such as phenome- 2010 9 nology (n = 6), grounded theory (n = 3), ethnographic 2009 studies (n = 2), action research (n = 1) and case study (n = 8 2008 1). These qualitative studies mark the changing para- 2007 7 digms in search of the entire phenomenon and much the 2006 broader approach to reality. Eight doctoral studies that 2005 6 combined qualitative and quantitative methods, without 2004 5 2003 showing a trend, do however demonstrate clarity of pur- 2002 4 pose for the domain of triangulation for broader and 2001 3 deeper knowledge on the object of study. 2000 For the distribution of 56 doctoral theses’ theoretical 2 1999 foundations and/or applications, nine doctoral theses 1998 1 1997 generated specific theoretical or conceptual models in 1996 0 their own studied areas. Thirteen doctoral studies directly tested existing theories or applied some conceptual mod- els as study frameworks. Twenty-one doctoral theses Year Number of theses failed to describe definite theoretical or conceptual mod- Figure 1. The number of nursing doctoral theses in Hong Kong els as study frameworks. Therefore, it was revealed a from 1996-2010. trend towards space for improving the theoretical and Copyright © 2012 SciRes. OPEN ACCESS 348 Y. C. Zeng, S. Pang / Open Journal of Nursing 2 (2012) 346-350 Table 2. Nursing doctoral theses by research design (N = 56). which indicate the strength of nurses’ contribution to patients’ health outcomes and practice advancement. The Study designs n % overview trend of these doctoral theses was that cardio- Quantitative studies 35 62.5 vascular rehabilitation care was the most often-studied Descriptive 2 3.6 topic, meeting the priority health needs faced by the HK Exploratory 5 8.9 population. According to the HK Department of Health’s Quasi-experimental/experimental 28 50.0 Thematic Household Survey Report [20], disease of the heart or circulatory system is the most commonly cited Qualitative studies 13 23.2 disease requiring long-term follow-up care. Phenomenology 6 10.7 The more recent trend among these doctoral studies Grounded theory 3 5.3 was for the predominant approach to be related to the Ethnographic 2 3.6 construction of a technical basis for care in HK. In the past two years, five theses [21-25] have focused on ex- Action research 1 1.8 amining technological advancements in nursing care. For Case study 1 1.8 example, Lam [22] conducted a clinical evaluation of Mixed methods 8 14.3 non-invasive blood glucose measurement.